A Case of Penetrating Fish Hook Ocular Injury

PURPOSE: To report a case study of a penetrating fish hook ocular injury. CASE SUMMARY: A 53-year-old male visited the emergency department complaining that he injured his eye with a fish hook. He had no specific ophthalmologic or medical history. A fish hook had penetrated the sclera 1.5 mm temporal to the limbus. The tip of the fish hook was visible at the posterior surface of the lens. His visual acuity was hand motion. The fish hook was removed through the entrance wound using the backout method. Anterior chamber irrigation and extracapsular cataract extraction with phacoemulsification were performed and intracameral antibiotic injection administered. Intraocular lens implantation was performed at a later date. Presently, the patient has a best correctional visual acuity of 0.7 with no signs of infections. CONCLUSIONS: In cases of ocular fish hook injury, determining a removal method is crucial for recovery. Herein, we report a case of successfully treated fish hook ocular perforation along with a literature review.

Factors Influencing Final Visual Acuiry After Penetrating Ocular Infuries

We analyzed the records of 124 eyes of 124 perforating ocular injury patients retrospectively from June 1 1994 to examine the relationship between final visual acuity and preoperative factors such as age, sex, initial visual acuity, location of injury, length of injury, mechanism of injury, intraocular foreign body, traumatic catarcact, secondary operation, hyphema, vitreous hemorrhage. The preoperative factors that influence final visual were age, initial visual acuity, length of infury, vitreous hemorrahage, secondary operation. However, other factors such as gender, mechanism, location of injury, intraocular foreign body, traubatic cataract, and hyphema did not influence final visual acuity. Final visual acuity was better in the case of young patients, good initial visual acuity were age, initial visual acuity, length of injury, vitreous hemorrhage, secondary operation, However, other factors such as gender, mechanism, location of injury, intraocular foreign body, traumatic cataract, and hyphema did not influence final visual acuity. Final visual acuity was better in the case of young patients, good initial visual acuity, short wound length, absence of vitreous hemorrhage and secondary operation.

A Clinical Study of Penetrating Ocular Injuries

To evaluate the epidemiological features of penetrating ocular injuries and to indentify factors influencing visual outcome we analyzed retrospectively 410 eyes of 402 patients who were treated at St. Mary's hospital from January 1, 1984 to December 31, 1994. Three hundred thirty four (83.1%) of the patients were male and the peak age was the third decade in both sexes. Little seasonal variation was noted. The accidents occurred more frequently at 4-5 p.m. and 10-12 p.m. and the peak time varied according to the type of accidents. Home accidents(27.4%) were the most common and traffic accidents(24.9%), industrial accidents(22.4%) came next. Two hundred fourteen (53.2%) were inflicted by sharp objects such as spectacles or glass. The cornea(63.1%) was the most common site of perforation and the laceration tended to occur at corneal conter, 6-10mm in length (37.5%). Conjunctival laceration(21.7%), lid laceration(33.2%) and the lens damage(31.5%)were accompanied. The most common surgical procedures was primary closure(83.2%), followedby lid repair and lens aspiration. Evisceration was performed in 54 eyes(13.2%), and the traffic accidents and blunt trauma were the main cause of the procedure. Final visual acuity was better in eyes with only corneal laceration than in eyes with scleral involvement.

Analysis of the Penetrating Ocular Injuries Involving the Posterior Segment

We analyzed retrospectively 39 cases of 39 patients who had undergone surgery for penetrating ocular injury involving posterior segment to investigate the effect of pars plana vitrectomy on visual outcome and anatomical success. Patients who received surgery between January, 1990 to October, 1994 were included. The patients who underwent pars plana vitrectomy were classified to 'vitrectomy group', and those who had not undergone vitrectomy were classified to 'primary repair group'. There were no significant differences in severity of ocular injury between the two groups. The vitrectomy group had significantly better result in functional success(visual result) and the anatomical success. Success rates of the two groups were compared in the presence of poor prognostic factors, including initial visual acuity worse than hand motion, hyphema more than 50%, vitreous hemorrhage, retinal detachment, laceration longer than 7mm, located more than 6mm posterior to the limbus. Vitrectomy group showed better results in the presence of each factor.

The Effect of the Prophylactic Cryopexy in the Experimental Penetrating Ocular Injury with Retinal Laceration

Retinal detachment was studied in a rabbit model of penetrating ocular injuries with retinal laceration. In experimental group, to study its effect on the prevention of retinal detachment, cryopexy was performed at the site of penetrating ocular injury. No retinal detachment was found when the injury was made in 3 mm radial incision from corneoscleral limbus. When the injury was extended to the equator of the globe, namely 6 mm radial incision from corneoscleral limbus, the incidence of retinal detachment was 35%. But when the incision was made circumferentially 6 mm through the retina near ora serrata ie, 3 mm from the limbus, the incidence was 65%. The higher incidence of retinal detachment following injuries located at the ora serrata is probably due to the involvement of the vitreous base. However, there was no significant difference in the incidence of retinal detachment between control and experimental groups. And the cryotherapy can release viable retinal pigment epithelial cells into the vitreous cavity which can cause proliferative vitreoretinopathy. Therefore, the cryotherapy should be limited in posterior penetraring ocular injuries. The histopathologic examination of proliferative vitreoretinopathy in rabbit eyes with posterior penetrating ocular injuries revealed Muller cells, fibroblast and retinal pigment epithelial cells as main cellular components. Through this experiment, cryopexy was proved to be little effect in prevention of retinal detachment in rabbit eyes with perforating eye injuries.